URODYNAMIC FINDINGS IN FEMALE PATIENTS REPORTING WITH LOWER URINARY TRACT SYMPTOMS

Nazli Hameed, M Asghar Ali, Waqar Azim

Abstract


Objective: The study has been undertaken to determine the reproducibility of lower urinary tract
symptoms in female patients after urodynamic investigations. Design: A Descriptive study with
retrospective analysis of data. Setting: Combined Military Hospital Rawalpindi and Armed Forces
Institute of Urology, Rawalpindi. Methods: Fifty consecutive women with a primary history of
urinary incontinence were interviewed on a standard urinary incontinence questionnaire. They
underwent structured clinical pelvic examination, along with cough stress test. Post void residual
urine was measured. This was followed by a urine routine examination to exclude any urinary
infection. Later these patients underwent a combination of urodynamic tests to predict their final
diagnosis. The tests performed were filling cystometry and leak point pressures. Results: The
clinical diagnosis was found to have a variable reproducibility on urodynamic investigations.
Clinical stress incontinence translated as genuine stress incontinence in 61.5% of the cases.
Patients with isolated symptoms of stress incontinence had an incidence of detrusor instability up
to 33.3%. For the symptoms of urgency and urge incontinence, the diagnosis was reproducible in
up to 50% of the cases. In cases of mixed symptoms, 20% patients were found to have stress
incontinence and 33.3% cases were found to have an unstable bladder, whereas in 46.6% of the
cases no objective abnormality was found on urodynamic investigations. Conclusion:
Urodynamic investigations should be performed in female patients with lower urinary tract
symptoms, especially if irreversible procedure, e.g., surgery is being contemplated.
Keywords: Urinary incontinence, stress incontinence, cystometry, leak point pressure, urinary tract

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